Individual
PAULA BUSHMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4020 SW 54TH AVE, DAVIE, FL 33314-3735
(954) 260-1481
(954) 252-4424
Mailing address
4020 SW 54TH AVE, DAVIE, FL 33314-3735
(954) 260-1481
(954) 252-4424
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
E2070 MEDICARE
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
V1484
BC/BS PROVIDER NUMBER
FL
Enumeration date
07/07/2006
Last updated
04/23/2008
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